199433 07/20/2011 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
Q ONE CIVIC SQUARE DONLEY SAFETY
CARMEL, INDIANA 46032 5546 ELMWOOD AVE CHECK AMOUNT: $74.64
INDIANAPOLIS IN 46203 CHECK NUMBER: 199433
CHECK DATE: 7/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 31094 74.64 REPAIR PARTS
INVOICE
Please visit us on the web at www.donleysatety.com
Phone 317 -786 -2268 Date Invoice
5546 Elmwood Ct. Fax 317- 786.2532
Indianapolis, IN 46203 6/15/2011 31094
Bill To Ship To
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN. 46032
USA
P.O. Number Terms Salesperson Ship Via F.O.B. S.O.
A -45 Due on receipt FS UPS
Ordered Shipped Bio Item Number Description Unit Price UOM Ext. Price
2 2 10002050 HUB COVER, SS, FRONT 26.63 53.26
2 2 10002417 HUB COVER LOGO 6.25 12.50
1 I FREIGI -IT SHIPPING HANDLING 8.88 8.88
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 $74.64
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Piease call 317- 786 -2268.
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
31094 A45 $74.64
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
VOUCHER NO. WARRANT N
ALLOWED 20
Donley Safety
IN SUM OF
5546 Elmwood Court
Indianapolis, IN 46203
$74.64
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1120 I 31094 I 42- 370.00 I $74.64 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
jUt 1 8 2011
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund